My grandmother is a 65-year-old retired teacher. Lately, she has been experiencing memory problems, such as forgetting appointments, misplacing keys, and struggling to recall the names of familiar people. What could it be and is there anything that could be done

Answered by Rishav Koirala, psychiatrist and researcher

Age-related cognitive changes are common, and some degree of forgetfulness is considered a normal part of aging. Chronic stress can lead to cognitive difficulties, and addressing stress management techniques may help improve memory. Sleep disturbances, such as sleep apnea or insomnia, can also impair cognitive function, and optimizing sleep quality can have a positive impact. 

If your grandmother is on some medication regimen, there are some drugs that may be affecting her memory. So a review of her medication is essential. Additionally, addressing any underlying medical conditions and ensuring proper nutrition can play a crucial role in memory improvement.

With the aging population in Nepal, the prevalence of cognitive disorders, including dementia, has been on the rise. In the context of dementia, individuals may experience a distorted sense of temporal orientation, emphasizing past memories while struggling to remember or anticipate the future. This temporal disorientation can lead to a sense of ‘wandering’ through time, where past experiences become more accessible, while future events and plans become increasingly elusive. 

As a result of this temporal disorientation, individuals experiencing memory problems may also find it challenging to remember tasks or work that was in progress, which can be disruptive and disorienting. This issue can further compound the difficulties associated with dementia, as individuals may ‘lose track’ of their ongoing tasks, adding to their sense of temporal disorientation and causing frustration and confusion. Understanding and addressing these challenges are essential in providing appropriate care and support to individuals with dementia.

Moreover, it’s crucial to recognize that the person looking after the patient, such as family members or caregivers, may experience significant emotional and psychological challenges. The constant adjustments and uncertainties brought about by dementia can lead to caregiver anxiety, stress, and burnout. Caregivers often grapple with the demanding responsibilities of ensuring the patient’s safety, providing emotional support, and managing the daily care routine, all while witnessing the progressive decline of their loved one's cognitive function. Recognizing and addressing the caregiver’s well-being is a vital aspect of holistic care for individuals with dementia, as it helps ensure the patient receives the best possible support while also maintaining the caregiver’s own mental and emotional health.

To determine the exact cause and appropriate interventions, it is crucial for your grandmother to seek a comprehensive evaluation from a healthcare professional, be it a psychiatrist, neurologist, or geriatrician, who can provide a tailored assessment and guidance for her specific situation. Early intervention and support can significantly affect the management of memory issues, irrespective of their underlying cause, and may involve addressing temporal disorientation and providing a supportive environment for individuals with dementia.